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Physio therapy Flashcards

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1
Q

Who is Mikey Dickerson?

A

Mikey Dickerson is known for leading the healthcare.gov rescue effort and founding the U.S. Digital Service.

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2
Q

What is the U.S. Digital Service?

A

The U.S. Digital Service is an organization that focuses on improving government services through technology.

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3
Q

What type of consultancy does Mikey Dickerson co-run?

A

He co-runs a consultancy that addresses organizations with difficult, near-intractable problems.

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4
Q

What is a key issue in government software procurement?

A

Government procurement often lacks a market-driven thought process.

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5
Q

How does the government approach software projects differently from individuals?

A

The government often buys unique products that no one else will purchase, leading to incoherent requirements.

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6
Q

What is a common problem with government requirements for projects?

A

Requirements are often created by committees, resulting in conflicting and impractical specifications.

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7
Q

Fill in the blank: Government procurement processes have ______ steps.

A

80 zillion

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8
Q

True or False: Government procurement is similar to how individuals buy products in a market.

A

False

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9
Q

What is the effect of having multiple committees in the procurement process?

A

It can lead to a list of requirements that is incoherent and unrealistic.

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10
Q

What analogy does Mikey Dickerson use to explain government procurement?

A

He compares it to buying a car, where the government lists all desired features without considering trade-offs.

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11
Q

What happens when a contractor points out costly requirements?

A

They may face backlash, as their role is to meet the specifications provided by the government.

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12
Q

What is a major flaw in how government contracts for software are structured?

A

Contracts often expect most failure to occur during the design and build phase, rather than during ongoing operation.

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13
Q

Who are two individuals mentioned that contribute to the discussion of government procurement?

A

Dave Gino and Jennifer Paulka.

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14
Q

What does the term ‘feedback loops’ refer to in the context of government procurement?

A

It refers to the lack of mechanisms to evaluate and improve processes based on past experiences.

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15
Q

What is the significance of the healthcare.gov rollout?

A

It serves as a case study for systemic issues in government software procurement.

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16
Q

What was the role of VaccinateCA?

A

VaccinateCA aimed to help improve vaccine discovery during the COVID-19 pandemic.

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17
Q

What is one consequence of the government’s approach to spending in procurement?

A

There is often no incentive to minimize costs, leading to inflated budgets.

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18
Q

Fill in the blank: The government often lacks ______ on procurement requirements.

A

back pressure

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19
Q

What does Mikey Dickerson suggest about the government’s understanding of trade-offs?

A

The government often does not recognize that some requirements may be mutually exclusive.

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20
Q

What is the expected release year of the upcoming book by Mikey Dickerson’s consultancy?

A

2026

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21
Q

What is one reason for the inefficiencies in government software procurement?

A

The lack of a coherent process and the influence of multiple committees.

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22
Q

What is a key takeaway for reformers regarding government procurement?

A

Understanding the systemic issues that lead to procurement failures is crucial.

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23
Q

What percentage of the effort in software lifecycle is expected to occur after launch?

A

90% plus

This statistic highlights the disproportionate focus on the design and build phase compared to ongoing maintenance and operation.

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24
Q

What issue arises from how government contracts are written for software procurement?

A

They expect 90% of failure to occur in the design and build phase, leaving only 10% for ongoing operation

This creates a misalignment between the actual software lifecycle and the contractual expectations.

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25
What was the primary reason for the tight deadline in the case of healthcare.gov?
Political exigencies ## Footnote It was a centerpiece of the administration's agenda.
26
What was a significant problem faced by California's vaccine scheduling system, MyTurn?
Lack of data flow between county health department portals and MyTurn ## Footnote This led to non-synchronized information and conflicting data.
27
What is a common pattern observed in government and political organizations?
Decentralized and disempowered structures leading to duplication of efforts ## Footnote This results in poor collaboration and inefficient outcomes.
28
True or False: The government has built systems that allow for more effective action than inaction.
False ## Footnote The brake pedal is more powerful than the gas pedal, leading to more stopping than action.
29
What is the misconception about government employees' competence?
That government employees are universally incompetent ## Footnote The reality is more complex, with a spectrum of competence among employees.
30
Fill in the blank: The government has approximately _______ civilian employees.
1.8 million ## Footnote This figure does not include state, county, and city government employees.
31
What does the term 'stop energy' refer to in government operations?
The tendency for government structures to resist change and action ## Footnote This leads to inefficiencies and delays in decision-making.
32
What is the implication of having many independently elected officials in California?
Lack of accountability and collaboration between different branches of government ## Footnote This creates challenges in implementing cohesive policies.
33
What was a major issue during the vaccine rollout in California?
Rapidly changing policies leading to confusion among medical providers ## Footnote Pharmacists often received outdated or conflicting information about policies.
34
What do the authors suggest about the size of the government workforce?
It spans the entire gamut of competence from incompetent to highly skilled individuals ## Footnote This complexity makes it unhelpful to generalize about the competence of government employees.
35
What issue did the VaccinateCA project highlight regarding local government responses during the pandemic?
Local governments often operated independently without coordination ## Footnote This led to inefficient vaccine administration and scheduling.
36
What was the effect of the decentralized government structure on vaccine scheduling?
Duplication of efforts and conflicting systems ## Footnote This resulted in inefficiencies and confusion for the public and health providers.
37
What does the term 'go energy' refer to in government operations?
The capacity and willingness of government to take action ## Footnote This is often countered by the stronger 'stop energy' that hinders progress.
38
What did Mikey Dickerson indicate about the relationship between government size and employee competence?
A large workforce will inevitably include a range of competence levels ## Footnote This complicates the assessment of overall employee performance.
39
What is the GS-13 pay scale?
An occupational rung on the government pay scale, typically for senior scientists or managers, ranked 13 out of 15.
40
How do private sector performance management practices compare to government practices?
Private sector generally has a culture of rigorous performance management, while government has mixed practices, with some areas lacking performance management.
41
What is a significant challenge in government performance management?
It is often illegal or difficult to remove underperforming employees in certain areas, such as education.
42
True or False: Private sector companies handle performance management better than government entities.
False. While private sector may have better performance management, the difference isn't as significant as commonly believed.
43
What is the primary focus when optimizing complex systems?
The emergent behavior of the system overall.
44
What is a common issue with modernization plans in organizations?
They often fail to produce meaningful change and can become bureaucratic obstacles.
45
Fill in the blank: The California Employment Development Division is associated with _______.
unemployment insurance.
46
What is 'swivel chair integration'?
The practice of using two systems side by side, typically involving two monitors to access information from both.
47
What was a major finding from IRS modernization reports?
The IRS is overly reliant on individual laptops as authoritative sources for taxpayer documents.
48
What does the term 'aspirationally' imply in the context of system modernization?
It suggests that while ideal outcomes are intended, they may not be realistically achieved.
49
What is a common outcome of large software projects in government?
They often get bogged down in requirements and may only launch with a fraction of features implemented.
50
What does the term 'performance management' refer to?
Processes and practices aimed at improving employee performance.
51
What was a notable issue with the rollout of healthcare.gov?
It highlighted the risks associated with large software projects.
52
True or False: The goal of modernization is often to replace technology for its own sake.
True.
53
What role does the telephone play in the VaccinateCA effort?
It served as a reliable communication method to gather information about vaccine availability.
54
What is a significant barrier to effective system modernization?
Bureaucratic processes that prioritize outdated systems over necessary changes.
55
What does 'technology solutionism' refer to?
The belief that technology can solve all problems, often leading to unnecessary complexity.
56
What lesson was learned from the VaccinateCA experience?
The importance of using the least complex technology to achieve immediate goals.
57
What was the primary takeaway for government employees from the healthcare.gov rollout?
Big software projects are hugely risky from a project risk perspective. ## Footnote This perspective leads to a reluctance to take responsibility for software projects.
58
What was the solution proposed in 2021 for directing people to vaccines?
To tap on the Boston Children's Hospital's vaccine finder initiative. ## Footnote This initiative had a history of helping people with annual influenza vaccinations.
59
What is a significant issue within the federal civil service environment regarding rewards?
There is almost no positive reward for doing something exceptional. ## Footnote Recognition is typically limited to informal accolades rather than substantial rewards.
60
How does the civil service environment affect individual performance and risk-taking?
There is no punishment for chronic underperformance and punishment for exceptional underperformance. ## Footnote This leads to herd behavior and discourages innovation.
61
What is the role of the Senior Executive Service (SES) in the US government?
The SES is a class of executives responsible for managing large budgets and government functions. ## Footnote These individuals often have extensive experience in government operations.
62
What is a common problem faced by elected officials in relation to project management?
They are sensitive to a short media cycle, intervening in projects without understanding long-term implications. ## Footnote This can lead to mismanagement and lack of accountability in long-term projects.
63
What does Mikey Dickerson suggest about the complexity of government issues?
The complexity of issues like Medicare is too much for elected officials to fully understand and manage. ## Footnote This complexity often leads to ineffective governance.
64
Fill in the blank: The backlog of undetermined claims will grow unbounded until the new claims rate decreases if the inbound rate of claims per day exceeds what the _______ can complete in a day.
[slowest, lowest throughput part of the system]
65
What did Mikey Dickerson observe about knowledge in organizational science?
Much knowledge from the past about managing large organizations has been forgotten. ## Footnote This includes important principles that were once applied in the 1950s and 1960s.
66
What historical example highlights the loss of applied mathematics in American industry?
The American automobile industry's neglect of statistical confidence intervals after WWII. ## Footnote This allowed Japanese manufacturers to gain a competitive edge by applying these principles.
67
True or False: Both science and technology are a monotone function where we get better year after year.
False. ## Footnote There are periods where knowledge and techniques are lost, impacting performance in various fields.
68
What is a key point about the evolution of science and technology according to Mikey Dickerson?
Science and technology are not a monotone function; improvements can be accompanied by losses.
69
What does Mikey Dickerson suggest about helping failing institutions?
You cannot help an institution that isn't asking for help; motivation must come from within.
70
What is the major condition for a successful tour of duty in National Service?
There needs to be a landing place that meets specific conditions and is receptive to help.
71
What does Mikey Dickerson say about the healthcare.gov project?
It was a generational opportunity where things initially went badly but improved through collaboration.
72
What is the primary focus of Mikey Dickerson's current advice on career transitions?
The existence of a receptive opportunity is crucial for a good experience.
73
True or False: Mikey Dickerson believes that you can make an organization care about something it currently does not.
False.
74
Fill in the blank: Mikey Dickerson recommends taking a _______ after a career in tech.
tour of duty
75
What social media platform does Mikey Dickerson maintain for sharing his thoughts?
LinkedIn.
76
What kind of stories does Mikey Dickerson relate to the improvement of institutions?
Stories of rescue and collaboration that lead to better outcomes.
77
What is the significance of storytelling in the context of healthcare.gov according to Mikey Dickerson?
It played a crucial role in how the narrative of improvement was perceived.
78
Where can people find Mikey Dickerson's published writings?
On Medium and his company website layeraleph.com.

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